Hi, my name is Justine Reilly. I'm one of the OB-GYN generalists
here at UT Health Austin, and I'm here today to talk about the
answers to some of your most searched questions regarding the second trimester. So what happens to my body
in the second trimester? During the second trimester the
baby starts as the size of a lemon, but starts to grow substantially
in length and in weight. And so at this point, your body also
starts to change with the growing baby, right? The uterus and your abdomen are
gonna start to get a little bit bigger. By 20 weeks, the baby's up to your belly
button. So this is really, you know, weeks 14 to 27 or the second trimester
when people really start to show. With that comes a lot of
hormonal changes of pregnancy. And a lot of those symptoms are normal. Should I be eating more
during the second trimester? So I think it's kind of a common
misconception that people think that they should be quote unquote eating for two. I actually tell my patients that you
probably should just be eating twice as healthy. Typically their recommendation is to
increase your caloric intake by about 350 calories per day. This is about like, this is like a glass of
milk and a half a sandwich, or like a bowl of oatmeal and a
banana. So it's not significantly much. Obviously that's, that's
twice that for twins and, and so on in multiple pregnancies. So what symptoms are abnormal and
when should you call your doctor? Although we know that the risk of
miscarriage decreases pretty significantly after the first trimester, there still is potential to have
complications like bleeding, um, cramping. And especially if those
things become heavy or severe, or if you have leakage of fluid, that's either kind of large in
volume or really persistent. These are all things that
we should know about, cause those can be signs of complications
like preterm labor and other placental abnormalities. So what
symptoms are normal? Usually in the second trimester, some of the morning sickness has worn off. We actually tend to refer to this
as like the honeymoon period of your pregnancy, cause you don't feel so
profoundly fatigued and you're
not throwing up anymore. And so there are symptoms that are
normal in the second trimester, and they tend to be related
to the hormonal changes
like we were talking about. So things like acid reflux, constipation, there's skin changes, you know, darkening of the face and sometimes
the line in your lower abdomen. So probably increased vaginal
discharge, increased sex drive. And there are a few other
things that can happen, but they're mostly pretty mild.
However they can be bothersome, so of course let us know. There's lots of medications that are
safe to treat all of these things. Are there specific screening tests or
genetic testing that you should have in your second trimester? Commonly in the second trimester we're
going to order what's called the anatomy scan. This is an ultrasound that looks
in depth at the parts of the baby. Just making sure that
there are no anomalies. This in combination with some of the
blood work that we do in the first trimester usually is gonna tell us a
lot about whether the baby has down syndrome or other anomalies.
And then around 24 to 28 weeks, we actually screen people
with blood work for anemia, which is super common in pregnancy as
well as for gestational diabetes or diabetes of pregnancy. And then you potentially could have
follow up testing depending on the results of all the screening that we do,
including the scan and the blood work. What complications can
arise during this trimester? Like I said, the second trimester
tends to be pretty benign, and a little bit of a
honeymoon period, but you know, you still are at risk for some
complications. Preeclampsia, however rare it is sometimes does
present in the second trimester. So we'll always be monitoring your blood
pressure and let us know if you have problems like persistent
headaches, despite taking Tylenol, visual changes or you know, belly
pain up in your right upper side, cause that's where your liver
is. Additionally, you know, pregnant women are somewhat
immunosuppressed, so
infections are more common. So things like UTI symptoms are things
you would definitely want to let us know about. Similarly COVID, you know, in this day and age is
a significant concern. So you wanna make sure that you
have been vaccinated and boosted. When will I feel my baby move and kick? Usually around 18 to 20 weeks is when
you're going to start noticing what women describe as like
a fluttering, you know, the babies move actually
starting at 10 weeks, but they're just too
small for you to feel it. Typically women who've been pregnant
before will feel it kind of sooner, but you know, I don't really expect
anyone to feel it until 20 weeks or so. And then it's not really reliable
as a marker of fetal wellbeing until later in the pregnancy,
as far as, you know, your partner or anybody
else being able to feel, I would say usually around more
like 24 weeks and later. Um, but you know, it's always an
exciting experience for sure. When should I start counting fetal kicks? Around 26 to 28 weeks, the movements of the baby become kind
of a reliable marker of well being. Depending on how high
risk your pregnancy is, you may get told to do
it more or less often. It's also really helpful for
women to know that, you know, this is something that
you can do, counting fetal
movements whenever, you know, you're wondering whether
the baby moving normally, typically you wanna get
10 movements in two hours, but just talk to your doctor and we'll
be able to let you know how often you should be doing this if at all. When may I learn the sex of my baby? So the genetic sex of the
baby oftentimes is able to be identified on the blood test in
the first trimester that's done to assess for chromosomal abnormalities.
But oftentimes we can add in, we want to know the sex
of the baby as well. If you haven't gotten that
information in the first trimester, usually around 18 to 22 weeks, when we do that anatomy ultrasound, we're able to identify whether the
baby is genetically male or female based off of ultrasound characteristics. So when should I start
sleeping on my side? So there's actually, you know, some evidence that in the third
trimester going to sleep on your back is associated with some
increased risk of stillbirth, but we actually have really good newer
data that tells us before 28 weeks, which is essentially the first and
second trimester that there's no risk of increased complications in pregnancy
if you're sleeping on your back. So I typically tell my patients
that in the third trimester, that's the time at which if they're
usually a back sleeper that I would try to start going to sleep on on your side.
And it doesn't really matter which side, classically we told people the
left just because of blood supply, this is all about blood supply, but ultimately the third trimester
sleeping on your side is, is totally fine prior to
that, you know, don't worry. I also wouldn't worry if you wake
up on your back anyway, just, again, if you're in the third trimester,
flip to one of your sides. So I hope I've answered your
questions about the second trimester. Keep in mind that every
patient is different. And you want to talk to your own
OB-GYN about your specific case, especially if you have
any high risk conditions. Thanks again for joining us today and
stay tuned for the third trimester video.
